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A Randomised Placebo-controlled Clinical Trial of Ultrasound and Electrotherapy Supplementary to Physiotherapy Exercises for Shoulder Disorders
lirkrracw Basso. D M rtnd Knapp, L (1587) y;omperbon of tm, ambr~ wus passh motion protoculo for patients wrth total knee nlvknw. ptrvsicsr 3. -.
m.
Daniels, L and Worthtngham, C (1972) Muscle Tesrcog, W B saunders company,Ptn3rd edibon. pages 5 6 4 1 M.J N el al ( l m ) 'Rationrde o( the Knee Soaety din& rathg system'. C h d Olthopeedics.248,13-14 h u g , J and Wood. L T (1988) 'Efficacy of neuromuscular sbmulatlon of the quadrhps fmons dunng mtinuous passive motion fdlowhg total knee arthtophsty'. Archfves of Physical h4mkmeand Rehabrlrtabon, 89,423424 Johnson. 0 P (1990)The effects of Con~nuouspassive mobon on woundhealing and joint mobility after k n e e arthroplasty', &&dh8M&M%m, 724.3,421-426
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Manske, P R and Gleeson. P (1977). 'Rehabilitation prooram f o l l d v potycenbicw 9-a p h v x a l ~ , 57,8,915-917. Nadler. S F, Malanga, G A and Zlmmerman, J R (1993). 'Continuous passive motion in the rehabilitation setting', Amsrican h m a l of P h y s k l Me&doe and Rehabilitafion, n, 3,162-165. Ritter. M A, Ganddf. V S and Holston. K S (1989). 'Cmtini.io~~ passive motion versus physical therapy in lotal k n e e arthroplasty', Clinical Orihq~edics,244,239-243. Tew, M eta/ (1 989).'Effectof total knee arthroplasty on maximal Rexion'. Cfinical Orthopaedcs 247,168-174. Yoshino. S, Shoji, H and Kcmagamine. M (1990).'Full Rexion and total knee replacement in rheumatoid arthritis', lntemtionsll m e d i c s , 14,13-16.
Lake. P and Moore, F (1990) 'Conbnuous passwe mobillsabcm following total knee replacement A retrospectlve review'. Austrapen Journal d W W r a p y , 38.2,93-97
A Randomised Placebo-controlled Clinical Trial of Ultrasound and Electrotherapy Supplementary to Physiotherapy Exercises for Shoulder Disorders G van &r HeGden P Knipschild J Verhe@len H van Mameren
P Leffers L Bouter P Woltem J Houben
Background: At least 10% of all referrals for physiot h e r a p y concern s h o u l d e r disorders. T r e a t m e n t includes ultrasound and electrotherapy. However, their efficacy has not been established. Objectives: To a s s e s s t h e effectiveness of electrotherapy (ET)and ultrasound (US)as supplementary treatment to physiotherapy exercises for patients with shoulder disorders.
Desrgn: Randomised placebo-controlled clinical trial with factorial design.
Physkthsrapy,Augcut 1995,v d 81,no 8
Methock: Patients with pain and/or restricted range of motion of a shoulder, a n d no underlying systemic disorder were eligible. After two weeks of exercises patients qualified for inclusion if their complaints did not improve much. Informed consent was obtained and prognostic information w a s documented. Patients were randomised into five groups: (1) US & ET,12) US & placebo-ET, (3) placebo-US & ET, (4) placebo-US & placebo-ET, (5) no treatment. Randomisation was prestratified for physiotherapy practice and the dominance of t h e impaired side. I n six weeks, 12 treatments with exercises and the allocated treatments were given. Patients and t h e metrist were blinded for treatment allocation; physiotherapists only for US. Recovery, shoulder pain, main complaint, functional status and range of shoulder motion were determined by patients and t h e metrist at 1.5, 3, 6 , 9 and 12 months after randomisation. Results: 180 patients have been randomised and the 1.5 months results have been analysed. So far, there has been no dropout or loss to follow up. The recovery rate aRer 1.5 months for the no treatment group was 20%.For US uersus placebo-US the recovery rates were 19% and 26% and for ET uersus placebo-ET 21% or 23%. None of the differences was statistically significant. The results up to six months will be presented.
m.
Daniels, L and Worthtngham, C (1972) Muscle Tesrcog, W B saunders company,Ptn3rd edibon. pages 5 6 4 1 M.J N el al ( l m ) 'Rationrde o( the Knee Soaety din& rathg system'. C h d Olthopeedics.248,13-14 h u g , J and Wood. L T (1988) 'Efficacy of neuromuscular sbmulatlon of the quadrhps fmons dunng mtinuous passive motion fdlowhg total knee arthtophsty'. Archfves of Physical h4mkmeand Rehabrlrtabon, 89,423424 Johnson. 0 P (1990)The effects of Con~nuouspassive mobon on woundhealing and joint mobility after k n e e arthroplasty', &&dh8M&M%m, 724.3,421-426
-
Manske, P R and Gleeson. P (1977). 'Rehabilitation prooram f o l l d v potycenbicw 9-a p h v x a l ~ , 57,8,915-917. Nadler. S F, Malanga, G A and Zlmmerman, J R (1993). 'Continuous passive motion in the rehabilitation setting', Amsrican h m a l of P h y s k l Me&doe and Rehabilitafion, n, 3,162-165. Ritter. M A, Ganddf. V S and Holston. K S (1989). 'Cmtini.io~~ passive motion versus physical therapy in lotal k n e e arthroplasty', Clinical Orihq~edics,244,239-243. Tew, M eta/ (1 989).'Effectof total knee arthroplasty on maximal Rexion'. Cfinical Orthopaedcs 247,168-174. Yoshino. S, Shoji, H and Kcmagamine. M (1990).'Full Rexion and total knee replacement in rheumatoid arthritis', lntemtionsll m e d i c s , 14,13-16.
Lake. P and Moore, F (1990) 'Conbnuous passwe mobillsabcm following total knee replacement A retrospectlve review'. Austrapen Journal d W W r a p y , 38.2,93-97
A Randomised Placebo-controlled Clinical Trial of Ultrasound and Electrotherapy Supplementary to Physiotherapy Exercises for Shoulder Disorders G van &r HeGden P Knipschild J Verhe@len H van Mameren
P Leffers L Bouter P Woltem J Houben
Background: At least 10% of all referrals for physiot h e r a p y concern s h o u l d e r disorders. T r e a t m e n t includes ultrasound and electrotherapy. However, their efficacy has not been established. Objectives: To a s s e s s t h e effectiveness of electrotherapy (ET)and ultrasound (US)as supplementary treatment to physiotherapy exercises for patients with shoulder disorders.
Desrgn: Randomised placebo-controlled clinical trial with factorial design.
Physkthsrapy,Augcut 1995,v d 81,no 8
Methock: Patients with pain and/or restricted range of motion of a shoulder, a n d no underlying systemic disorder were eligible. After two weeks of exercises patients qualified for inclusion if their complaints did not improve much. Informed consent was obtained and prognostic information w a s documented. Patients were randomised into five groups: (1) US & ET,12) US & placebo-ET, (3) placebo-US & ET, (4) placebo-US & placebo-ET, (5) no treatment. Randomisation was prestratified for physiotherapy practice and the dominance of t h e impaired side. I n six weeks, 12 treatments with exercises and the allocated treatments were given. Patients and t h e metrist were blinded for treatment allocation; physiotherapists only for US. Recovery, shoulder pain, main complaint, functional status and range of shoulder motion were determined by patients and t h e metrist at 1.5, 3, 6 , 9 and 12 months after randomisation. Results: 180 patients have been randomised and the 1.5 months results have been analysed. So far, there has been no dropout or loss to follow up. The recovery rate aRer 1.5 months for the no treatment group was 20%.For US uersus placebo-US the recovery rates were 19% and 26% and for ET uersus placebo-ET 21% or 23%. None of the differences was statistically significant. The results up to six months will be presented.